​ICFOpeningProviderChecklist

An ICF opening can occur for multiple reasons, but most are related to the downsizing efforts, but some can be replacement facilities. This process outlines what is needed for the opening of a new ICF.

ICF Opening: Pre-move

Complete

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Activity

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Completed by

Sent to

1

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If the opening of new facility is part of larger downsizing plan or if any unique circumstances exist, contact DODD to discuss plans for development. Please contact Ann Weisent at 614-949-8792 or Ann.Weisent@dodd.ohio.gov.

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Provider

DODD

2

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Provider contacts OPSR to get development application, and completes development application at least 60 days prior to when the home will be ready for inspection and sends to DODD. Please contact Ann Weisent at 614-949-8792 or Ann.Weisent@dodd.ohio.gov.

Medicaid sends new provider application to the Ohio Department of Health (ODH) and DODD.

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Medicaid

ODH, DODD

5

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Medicaid begins reviewing the new provider application and attached documents.

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Medicaid

6

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DODD will review, research, and, when able, approve the development application and notify Provider, Medicaid, and ODH. OAC 5123:2-3-26(F) (2) gives DODD 60 days to respond to a development application.

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DODD

Provider, Medicaid, ODH

7

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Provider contacts DODD to schedule feasibility study when home is ready for inspection to ensure that the home meets all requirements according to Licensure rules. Provider can contact Ann Weisent at 614-949-8792 or Ann.Weisent@dodd.ohio.gov.

Provider

DODD

8

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DODD conducts on site feasibility study for licensure survey (per OAC 5123:2-3-02) typically within 30 days of notification from provider that facility is ready for the feasibility study.

DODD

9

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DODD issues a 30-day interim license as a residential facility (per OAC 5123:2-3-23). The interim license is made effective, and issued to the provider based on the date that the provider informs DODD that they will be moving individuals into the home. It may be renewed for up to an additional 150 days.

Provider calls EIDC help desk at 614-995-4263 to set up account for new facility. This allows the provider to see their report and submit plan of correction (POC) online, if needed. Provider should include an email address to receive notification when reports are available.

Provider must have at least one individual living in the residence when ODH comes for initial certification survey

Provider

14

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ODH performs initial certification survey; this is an on-site survey.

ODH

15

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ODH issues results of initial certification survey (statement of deficiencies) via EIDC (approximately 10 days after survey is conducted). Provider will receive an email notification of results if they included an email address when the EIDC account was created.

ODH

Provider

16

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If there are deficiencies listed, provider can submit a Plan of Correction (POC) if they intend to be certified. POC must include an Allegation of compliance date (which is the date by which the provider will come into compliance).

Provider

ODH

17

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ODH reviews and accepts POC (approximately 10 days after receiving POC). Provider will be notified of acceptance through EIDC.

ODH

Provider

18

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ODH schedules provider for re-visit to ensure deficiencies are corrected (typically less than 30 days from allegation of compliance date included in POC).

ODH

Provider

19

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ODH completes re-visit and, if deficiencies are corrected, recommends initial certification with effective certification date. Facilities cannot be certified until they are in compliance.

ODH

Provider

20

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If there are no deficiencies, ODH recommends initial certification with effective certification date.

Provider completes 9401 to discharge individuals from old provider number and to admit individuals to new provider number and submits to the County Department of Job and Family Services (CDJFS).

Provider

CDJFS

30

Provider completes Level of Care (JFS 3697) and submits to DODD. LOC requests need to be complete (physician signature, psychological, etc.) and submitted within 30 days of the date of admission. LOC can be submitted via fax to 614-466-0652, or via email to ICFDOC@dodd.ohio.gov.

Provider

DODD

31

DODD receives LOC, reviews, and approves or denies (typically within one-two weeks). An email is sent to provider acknowledging completion of LOC.

DODD

Provider

32

CDJFS reviews 9401 and looks for LOC. If LOC is complete, CDJFS processes 9401. CDJFS may contact provider if LOC is not complete in CRISE.

CDJFS

33

Once the 9401 is completely processed, the CDJFS sends the 9401 back to the provider.

CDJFS

Provider

34

Provider completes 9400s for payment changes, as needed, and faxes it to Medicaid LTC Payment Unit at 614-995-5959. Including a copy of the 9401 received back from the CDJFS is helpful.

Provider

Medicaid

35

Medicaid reviews and processes payment adjustments or sends notice of inability to process to provider.

Medicaid

Provider

36

Provider reviews and reconciles remittance on a monthly basis to ensure payment adjustments occurred. Provider may submit a second JFS 9400 to the LTC Payment Unit via fax to 614-995-5959 marked "Second Request" if they have not received payment adjustments 30 days after submitting the initial JFS 9400. Providers may call the LTC

If the person completing IAFs on behalf of the provider is not already a submission agent, they can become one by completing the security affidavit to become an IAF submission agent: sra.prodapps.dodd.ohio.gov/default2.aspx

Provider

DODD

38

DODD conducts an initial survey of the new facility approximately 45 days from the date of occupancy.

DODD

Provider

39

Provider completes 90 day cost report for new facility and submits to DODD. If provider is eligible for rate adjustments due to downsizing efforts, provider complete cost report type 4.8 in addition to the 4.2 required cost report.

Provider

DODD

40

DODD performs desk audit of cost report. DODD may contact provider with questions and may ask for resubmission of cost report if needed.

DODD

Provider

41

If provider files a 4.8 cost report and is eligible for a rate adjustment, DODD calculates adjusted rates for retroactive payment through MITS. Rate package is sent to provider indicating new rate.

DODD

Provider

Readiness Letter: When the provider sends their readiness letter to ODH, it is expected that the provider is in compliance with all certification requirements. Some important aspects include:

The provider meets all health and safety requirements.

The building is furnished: common areas should have enough furniture for expected capacity, bedroom furniture for person currently receiving services and provider will need to show ability to provide bedroom furniture for capacity (procedure, PO, etc.).

The provider is ready to provide goods and services: should have ability to store goods for capacity and have enough goods on hand for at least four individuals (since this is the minimum ICF capacity) for approximately one week and be able to show procurement process.

Staff are available.

All policies, procedure manuals, and other documents that need to be revised are ready to go and available for review.

The provider has at least one resident on site receiving services.

The IP for the resident and all necessary services for that person should be in place.